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PubMed1978

Pulmonary necrobiotic nodules without rheumatoid arthritis.

Pulmonary necrobiotic nodules are the least common of the pulmonary lesions associated with rheumatoid arthritis. Histologically they are identical to subcutaneous rheumatoid nodules. Systemic rheumatoid arthritis usually precedes the development of pulmonary nodules. Seven cases where the pulmonary nodule appeared before or without the development of systemic rheumatoid arthritis are described. The typical histological and radiological features of necrobiotic nodules were found in each. In five of the seven the nodules were in more than one site and in five there were cavitating nodules. Spontaneous improvement occurred in one case. Pulmonary nodules preceded systemic rheumatoid arthritis in three cases and in the remaining four cases systemic rheumatoid arthritis has not yet appeared despite prolonged follow-up. In all patients, tests for rheumatoid factor have remained negative. The absence of circulating rheumatoid factor and systemic rheumatoid arthritis cannot exclude the diagnosis in these cases if the histological diagnosis is accepted as conclusive.

Adult↗

PubMed2003

Cytokine profile of the rheumatoid nodule suggests that it is a Th1 granuloma.

OBJECTIVE: To define the cytokine profile within rheumatoid subcutaneous nodules, and to determine whether the destructive inflammatory process in this lesion displays features of a lymphocyte-driven Th1 or Th2 granuloma. METHODS: Subcutaneous nodules excised from 10 patients with rheumatoid arthritis were examined. Transcripts for interleukin 1beta (IL-1beta) IL-2, IL-4, IL-5, IL-10, IL-12, IL-13, IL-15, IL-18, and for tumor necrosis factor alpha (TNFalpha) and interferon-gamma (IFNgamma) were detected by reverse transcription-polymerase chain reaction of extracted RNA. RESULTS: Nine of 10 nodules contained transcripts for IFNgamma. We observed no evidence for the expression of IL-2, IL-4, or IL-5 among the lymphokine genes analyzed. Transcripts for TNFalpha, IL-1beta, IL-10, IL-15, and IL-18 were present in all 10 nodules. Transcripts for IL-12 were present in all but one nodule. Expression of IL-13 messenger RNA was observed in only 5 nodules. CONCLUSION: The cytokine profile within the rheumatoid nodule (i.e., presence of IFNgamma but not IL-2, and prominent expression of IL-1beta and TNFalpha together with IL-12, IL-18, IL-15, and IL-10) is similar to the profile of cytokines in the synovial lesion of rheumatoid arthritis, which is generally accepted as being attributable to a Th1-mediated inflammatory mechanism. Our results suggest that damage to affected synovial membrane or subcutaneous tissue is caused by the same inflammatory mechanisms, and that the nodule is a Th1 granuloma.

Aged↗

PubMed2007

Sonographic diagnosis of thyroid nodules: correlation with the results of sonographically guided fine-needle aspiration biopsy.

PURPOSE: To assess the reliability of sonography in differentiating benign from malignant thyroid nodules and selecting lesions for fine-needle aspiration (FNA). METHODS: During a 2-year period, the following 7 sonographic parameters were assessed in 129 patients with thyroid nodules: size, number, echogenicity, echotexure, margin regularity, presence of calcifications, and presence of a hypoechoic rim. Sonographically guided FNA was performed on thyroid nodules 5 mm in diameter. Out of 184 FNAs, we obtained 168 specimens adequate for cytologic analysis and 16 (9%) nondiagnostic specimens. RESULTS: FNA diagnoses included 150 (89%) benign and 18 (11%) malignant nodules. Among 53 solitary nodules, 11 were carcinomas and 42 were benign (p < 0.01). The mean size of the carcinomas was 28 +/- 12 mm versus 18 +/- 10 mm for benign nodules (p < 0.01). The following sonographic features were significantly associated with malignancy: hypoechogenicity, irregular margins, calcifications, and absence of a hypoechoic rim. Differences in echotexure between malignant and benign nodules were not statistically significant. CONCLUSION: Sonographically guided FNA should be performed on thyroid nodules 5 mm in diameter with sonographic characteristics that suggest malignancy.

Adult↗

PubMed1991

Rheumatoid nodules do not predict response to treatment with slow-acting anti-rheumatic drugs.

Rheumatoid nodules have been associated with a poor long-term prognosis. We investigated whether they predict a poor response to treatment with slow-acting anti-rheumatic drugs (SAARDs). Two hundred and twenty-eight patients with rheumatoid arthritis (RA) were treated for six months with a SAARD. Clinical and laboratory assessments of disease activity were made initially and after 6 months' treatment. Patients were divided into two groups according to the presence or absence of nodules at entry. Twenty-one % had nodules before treatment but their response was no different to patients without nodules (79%), both groups showing improvements in all variables. Males were more likely to develop nodules and had a relative risk of 1.7. High titres of rheumatoid factor correlated with nodules and no sero-negative patients had nodules. We conclude that nodules are not predictive of poor response to treatment with a SAARD, despite their presence being associated with a poor long-term prognosis. One possible implication is that SAARDs themselves, despite an early response, may not effect long-term outcome.

Anti-Inflammatory Agents↗

PubMed1993

Thallium-201 scintigraphy in the evaluation of thyroid nodules. A retrospective study of 246 cases.

There is controversy at present concerning the value of Tl-201 scintigraphy in the diagnosis of malignant thyroid nodules. The usefulness of Tl-201 scintigraphy in differentiating benign from malignant nodules was evaluated retrospectively. Tl-201 scintigraphy was performed in 101 patients with malignant thyroid nodules and in 145 with benign nodules. Early and late images were examined to compare Tl-201 uptake in nodules and normal thyroid tissue. The visual method resulted in 74% of sensitivity and 58% of specificity for the detection of malignant nodules including incidental cancers. Excluding incidental cancers, 87% sensitivity and 58% specificity were achieved. Small cancers, including incidental cancers less than 1.5 cm in diameter and small number of viable tumor cells in a large tumor also gave negative Tl-201 scintigraphic results. Forty-two percent of the benign lesions gave false positive Tl-201 scintigraphic results. It is concluded that Tl-201 scintigraphy is a sensitive and useful method to use in diagnosing malignant thyroid nodules, but is not a specific method even with late scan, for the detection of malignant thyroid nodules.

Adenocarcinoma, Follicular↗

PubMed2001

Non-palpable thyroid nodules in a borderline iodine-sufficient area: detection by ultrasonography and follow-up.

Thyroid ultrasonography was performed in 482 subjects, free of known thyroid disease and living in a borderline iodine-sufficient urban area, to assess the prevalence of non-palpable thyroid nodules and evaluation their evolute during a 3-yr follow-up. The mean (+/-SD) thyroid volume in the whole study group was 10.9+/-3.7 ml and was higher in males (12.9+/-3.6 ml) than in females (9.2+/-2.9 ml) (p<0.0001). Thyroid volume was correlated with body surface, height and weight, while no correlation was present with lean and fat body mass. Goiter was found in 5/256 females and in 13/226 males. Thyroid nodules were found in 27/482 subjects (18 females, 9 males). Single nodules were found in 17/464 subjects (3.66%) with a thyroid gland of normal volume and in 4/18 subjects (22.2%) with goiter (chi2=10.21; p=0.001). Multiple nodules were found in 3/464 subjects (0.6%) with a thyroid of normal volume and in 3/18 (16.6%) subjects with goiter (chi2=24.31; p<0.0001). The prevalence of thyroid nodules was significantly higher in females >35 yr than in those <34 yr (chi2=7.47; p=0.0062). A significant increase (>30%) of nodular volume was found in 5 subjects, while an increased number of nodules was found in 8. In conclusion, thyroid ultrasonography reveals the presence of thyroid nodules in a significant proportion of apparently thyroid disease-free subjects living in a borderline iodine-sufficient urban area. Incidentally discovered thyroid nodules are associated with goiter and are likely to progress in volume and number.

Adolescent↗

PubMed2002

Co-expression of interleukin-6 (IL-6) and interleukin-6 receptor (IL-6R) in thyroid nodules is associated with co-expression of CD30 ligand/CD30 receptor.

Data on the expression of interleukin 6 (IL-6)/interleukin 6 receptor (IL-6R) in thyroid nodules is scarce. Based on our recent data of CD30 ligand (CD30L)/CD30 receptor (CD30) in these nodules and on the knowledge that this signal stimulates IL-6 production in non-thyroid neoplasms, we wanted to evaluate the immunocytochemical expression of these 2 ligand/receptor systems in a large archival series of paraffin-embedded specimens. These specimens included 6 normal thyroids and 130 thyroid nodules. Co-expression of IL-6 and IL-6R in the epithelial (follicular) cells was observed solely in CD30L/CD30 positive nodules: 5/15 (33%) oncocytic adenomas; 6/30 (20%) follicular adenomas which belonged to 2 variants (4/4 microfollicular toxic and 2/2 hyalinizing trabecular); 9/30 (30%) papillary thyroid cancers (PTC), all belonging to the conventional variant. In PTC the proportion of tumor epithelial cells that were IL6 positive was inversely correlated with the pTNM staging (r=-0.549, p=0.01). All 15 follicular cancers (FTC), all 6 anaplastic cancers (ATC) were IL-6/lL-6R negative; 14/15 FTC and 5/6 ATC were CD30L/CD30 negative. In another oncocytic adenoma, another 4 conventional PTC and another 7 non-conventional PTC CD30L/CD30 expression was associated to expression of IL-6 only. IL-6 staining associated to absent expression of CD30L and CD30 was observed in 7 follicular adenomas (all belonging to variants different from toxic and hyalinizing trabecular), 2 oncocytic adenomas, 5 of the 30 colloid nodules and 2 normal thyroids. Of the 6 tumors arising from the parafollicular C cells (medullary thyroid cancer, MTC), all 3 that had metastasized were CD30L/CD30/IL-6 positive and IL-6R negative; only IL-6 expression was lost in both the local and distant metastases. This finding matched the loss of IL-6 expression in one PTC metastasis. All 3 non-metastasized MTC were IL-6/IL-6R negative, and 1/3 was CD30L positive/CD30 negative. We conclude that only in a subset of both benign and malignant thyroid nodules the IL-6/IL-6R signal could be induced by the CD30L/CD30. IL-6 expression is related with aggressiveness in both PTC and MTC. In the normal thyroid tissue, colloid nodules, and another subset of benign and malignant thyroid nodules, IL-6 expression is under control of signals other than CD30L/CD30.

Adenocarcinoma, Follicular↗

PubMed2003

Clinical relevance of non-palpable thyroid nodules as assessed by ultrasound-guided fine needle aspiration biopsy.

It is known from autopsy data that thyroid nodules are far more common than can be detected by palpation alone. With the wide use of modern non-invasive imaging many non-palpable thyroid nodules are discovered but the proper approach to these nodules is still debatable. In a retrospective study, we reviewed the data from 186 US-guided FNA biopsies (US-FNAB) performed between May 1995 and March 1997 at the Sapir Medical Center, Israel, a iodine-sufficient urban area. Sixty-one of the 186 US-FNAB of the thyroid were performed in non-palpable nodules. The mean size of these nodules was 2.4 +/- 1.0 cm (mean +/- SD) ranging from 1.1-5.5 cm. Description of the nodule consistency was available in 53 cases; 42/53 were solid and 11/53 were solid-cystic. FNAB was diagnostic in 46 patients and non-diagnostic in 15. Forty-three of the diagnostic cytology reports were benign, one revealed papillary carcinoma, one had suspicious findings and the third was suspicious for a follicular neoplasm. The last two patients were referred to surgery and a follicular adenoma was found in both. Among the 61 non-palpable thyroid nodules, only one was papillary carcinoma, a prevalence of 1.6%. The other two patients referred to surgery had benign lesions. We found a low prevalence of malignancy in relatively large non-palpable thyroid nodules.

Adult↗

PubMed2004

Slow growth of benign thyroid nodules after menopause: no need for long-term thyroxine suppressive therapy in post-menopausal women.

Benign thyroid nodules represent a very common disorder, the management of which is still controversial. The aim of the present work was to evaluate by ultrasound examination the volume changes of thyroid nodules in post-menopausal women presenting single palpable nodular goiter of recent onset (less than 6 months from diagnosis). Forty-three patients received L-T4-treatment, 38 represented the no-treatment group. Long-term follow up (3 and 5 yr) did not show any significant change in the mean volume nodule in these patients. In the no-treatment group, the mean nodule volumes were stable over time from baseline to 5 yr. No significant difference was observed at any follow-up evaluation between thyroid hormone treated and untreated patients. After 1 yr of treatment, a significant decrease (p = 0.0275) in mean nodule volume occurred only for nodules with a baseline volume lower than 1.5 ml. The frequency of clinically relevant nodule size variation showed a more frequent decrease (13.9%) at 1 yr in the L-T4 group, as compared to the no-treatment group (2.6%), while the proportion of increased volume at 1 yr was higher in the untreated than in the L-T4 group (5.3% vs 2.3%). This inverse relationship between the 2 groups was not statistically significant (p = 0.076). In conclusion, an arrest in the growth of benign thyroid nodules occurs in the majority of women after menopause. Only a very limited number of these patients may benefit from thyroid hormone suppressive treatment.

Female↗

PubMed2003

Ultrasonographic localization of occult pulmonary nodules during video-assisted thoracic surgery.

The aim of our study was to evaluate the role of ultrasonography in the localization of pulmonary nodules during video-assisted thoracic surgery (VATS). Ultrasonography was performed in 35 patients for the localization of pulmonary nodules during VATS. Indication for VATS was excisional biopsy of undetermined nodules in 22 patients, single or multiple metastasectomy in 12 patients and resection of primitive pulmonary cancer in 1 patient with reduced pulmonary reserve. A laparoscopic probe with flexible head and multi-frequency transducer (5-7.5 MHz) was used. Intraoperative ultrasonography localized 37 of 40 nodules preoperatively detected by CT and/or by positron emission tomography in 35 patients. Furthermore, ultrasonography localized two nodules not visualized at spiral CT. Eighteen nodules were not visible or palpable at thoracoscopic examination and were found by intraoperative sonography only. In 6 patients in whom thoracotomy was performed, manual palpation did not reveal more lesions than ultrasonography. In our experience, ultrasonography was very helpful when lesions were not visible or palpable during thoracoscopy, showing high sensitivity (92.5%) in finding pulmonary nodules. Since it is not possible to determine preoperatively whether a localization technique will be necessary during the operation or not, and ultrasonography is a non-invasive technique, we think that, at present, this technique can be considered as the first-instance localization technique during thoracoscopic resection of pulmonary nodules.

Adolescent↗

PubMed2005

Resolving small pulmonary nodules: CT features.

Our aim was to analyse the CT morphology of resolving nodules over time in order seek morphologic features helpful in initial nodule classification. The imaging characteristics of 133 consecutive resolving pulmonary nodules detected in 56 subjects in a screening trial for early lung cancer with low-dose CT were retrospectively reviewed by two readers in consensus. Nodule size ranged from 2 to 28 mm, with a mean diameter of 5.9 mm. The maximum diameter of resolving nodules was < or =5 mm in 71/133 (53%), 6-10 mm in 52/133 (39%), and >10 mm in 10/133 (8%). Their location was mainly peripheral, with a mean distance to the costal pleura of 10 mm. There was no lobe predominance of nodules. In 85% (113/133) of cases the nodules were solid, 77% (103/133) were well-defined, and 73% (97/133) were non-lobulated. Eighty percent (107/133) resolved completely within 14-1,671 (mean 492) days, 20% (26/133) resolved incompletely with residual abnormalities within 51-1,777 (mean 613) days. Resolving pulmonary nodules were mostly < or =10 mm, peripherally located, solid, well-defined, and non-lobulated. Most resolve completely within a variable interval ranging from several days to years.

Adult↗

PubMed2005

Value of axial and coronal maximum intensity projection (MIP) images in the detection of pulmonary nodules by multislice spiral CT: comparison with axial 1-mm and 5-mm slices.

The purpose of this study was to investigate the diagnostic accuracy of non-overlapping 10-mm axial and coronal maximum intensity projections (MIP) in comparison with standard axial 1-mm and 5-mm slices in the detection of pulmonary nodules. Sixty patients with suspected nodules who underwent multislice spiral CT of the chest were evaluated. Axial 1-mm and 5-mm slices as well as non-overlapping 10-mm axial/coronal MIPs were interpreted independently by three blinded radiologists. After initial review, a retrospective consensus session was performed for agreement on final nodule counts using the axial 1-mm slices as gold standard. Small nodules of less than 5 mm in size were most accurately detected by the axial MIPs. Receiver operating characteristic (ROC) analysis of these small nodules showed that 5-mm slices were not capable of a statistically significant differentiation of nodules from other focal lesions in two observers (p=0.034 and p=0.012, respectively) whereas 1-mm slices and coronal/axial MIPs did allow a statistically significant differentiation in all observers (p<0.001). Nodules larger than 5 mm were equally well depicted with all modalities. Non-overlapping 10-mm axial MIPs improve the accuracy in the detection of small pulmonary nodules.

Adolescent↗

PubMed2006

Pulmonary nodule detection with digital projection radiography: an ex-vivo study on increased latitude post-processing.

To evaluate increased image latitude post-processing of digital projection radiograms for the detection of pulmonary nodules. 20 porcine lungs were inflated inside a chest phantom, prepared with 280 solid nodules of 4-8 mm in diameter and examined with direct radiography (3.0x2.5 k detector, 125 kVp, 4 mAs). Nodule position and size were documented by CT controls and dissection. Four intact lungs served as negative controls. Image post-processing included standard tone scales and increased latitude with detail contrast enhancement (log-factors 1.0, 1.5 and 2.0). 1280 sub-images (512x512 pixel) were centred on nodules or controls, behind the diaphragm and over free parenchyma, randomized and presented to six readers. Confidence in the decision was recorded with a scale of 0-100%. Sensitivity and specificity for nodules behind the diaphragm were 0.87/0.97 at standard tone scale and 0.92/0.92 with increased latitude (log factor 2.0). The fraction of "not diagnostic" readings was reduced (from 208/1920 to 52/1920). As an indicator of increased detection confidence, the median of the ratings behind the diaphragm approached 100 and 0, respectively, and the inter-quartile width decreased (controls: p<0.001, nodules: p=0.239) at higher image latitude. Above the diaphragm, accuracy and detection confidence remained unchanged. Here, the sensitivity for nodules was 0.94 with a specificity from 0.96 to 0.97 (all p>0.05). Increased latitude post-processing has minimal effects on the overall accuracy, but improves the detection confidence for sub-centimeter nodules in the posterior recesses of the lung.

Animals↗

PubMed2006

Management of an incidentally discovered pulmonary nodule.

The incidental finding of a pulmonary nodule on computed tomography (CT) is becoming an increasingly frequent event. The discovery of such a nodule should evoke the possibility of a small bronchogenic carcinoma, for which excision is indicated without delay. However, invasive diagnostic procedures should be avoided in the case of a benign lesion. The objectives of this review article are: (1) to analyze the CT criteria defining benign nodules, nodules of high suspicion of malignancy and indeterminate nodules, (2) to analyze the diagnostic performances and limitations of complementary investigations requested to characterize indeterminate lung nodules, (3) to review the criteria permitting to assess the probability of malignancy of indeterminate nodules and (4) to report on the new guidelines provided by the Fleischner Society for the management of small indeterminate pulmonary nodules, according to their prior probability of malignancy.

Adenocarcinoma, Bronchiolo-Alveolar↗

PubMed1998

Pulmonary nodules: detection with low-dose vs conventional-dose spiral CT.

The purpose of the study was the evaluation of low-dose spiral CT in the detection and assessment of contours of pulmonary nodules. In a prospective investigation 71 consecutive chest CT examinations were acquired both at 30 and 200 mA. Films were interpreted independently by two radiologists. According to the size, nodules were divided into four categories: </= 3, 4-5, 6-10, and > 10 mm; nodule shape was registered. With both protocols, 240 nodules were detected. The correlation coefficient for both methods was 0.89. Discrepancies were found most frequently in nodules near to pulmonary vessels. Nodule size estimation did not differ more than one size category. Eight spiculated nodules were identified by both techniques. Low-dose spiral CT of the chest has a high sensitivity in the detection of pulmonary nodules. If clinical circumstances require dose minimization, low-dose spiral CT may be advocated as an alternative screening method to conventional dose spiral CT.

Adolescent↗

PubMed2000

Spiral CT of pulmonary nodules: interobserver variation in assessment of lesion size.

The aim of this study was to assess interobserver variability in size determination of pulmonary nodules at spiral CT. Twenty-three patients with known pulmonary nodules (diameter 2-40 mm, mean diameter 7 mm) underwent spiral chest CT (collimation 5 mm, pitch 1). Images were reconstructed at 3- and 5-mm intervals (RI). Hard copies were analyzed by two radiologists who recorded every nodule with regard to location, diagnostic confidence ("definite," "probable") and nodule size in increments of 1 mm with specific attention to correct classification into one of three size classes (< or = 5 mm, 6-10 mm, > 10 mm). Interobserver variability was determined with Pearson's correlation coefficient and kappa measure. Of a total of 286 nodules, 103 nodules were found accordingly by both readers at 3 mm RI, and 96 at 5 mm RI. There was a good correlation of measurements (in millimeters) between both readers (Pearson's correlation coefficient: 0.89-0.95). Interobserver variability in categories was good at both reconstruction intervals (kappa: 0.61 at 3 mm, 0.74 at 5 mm RI) and very good (0.81) at 5 mm RI when uncertain nodules were excluded. Spiral CT allows reproducible size determination of pulmonary nodules as shown by good interobserver agreement in exact size measurement and categorization into three size classes.

Calibration↗

PubMed2005

Computer aided characterization of the solitary pulmonary nodule using volumetric and contrast enhancement features.

RATIONALE AND OBJECTIVES: To investigate the utility of a computer-aided diagnosis (CAD) in the task of differentiating malignant nodules from benign nodules based on quantitative features extracted from volumetric thin section CT image data acquired before and after the injection of contrast media. MATERIALS AND METHODS: 35 volumetric CT datasets of solitary pulmonary nodules (SPN) with proven diagnoses (19 malignant/16 benign) were contoured by a thoracic radiologist. All studies had at least a baseline series obtained without contrast media and at least one series following an intravenous contrast injection at 45, 90, 180, and 360 seconds. Two separate contours were created for each nodule: one including only the solid portion and another including the ground-glass component, if any, of the nodule. For each contour 31 features were calculated that measured the attenuation, shape, and enhancement of the nodule due to the injection of contrast. These features were input into a feature selection step and three different classifiers to determine if the diagnosis could be predicted from the resulting feature vector. In addition, observer input was introduced to two of the classifiers as an a priori probability of malignancy and the resulting performance was compared. Training and testing was conducted in a resubstitution and leave-one-out fashion and performance was evaluated using ROC analysis. RESULTS: In a leave-one-out testing methodology, the classifiers achieved areas under the ROC curves AZ that ranged from 0.69 to 0.92. A classifier based on logistic regression performed the best with an AZ of 0.92 while a classifier based on quadratic discriminant analysis performed the poorest (AZ, 0.69). The AZ increased when using a priori observer input in most cases reaching a maximum of 0.95. CONCLUSION: Based on this initial work with a limited number of nodules in our dataset, it appears that CAD using volumetric and contrast-enhanced data has the potential to assist radiologists in the task of differentiating solitary pulmonary nodules and in the management of these patients. Further studies with an increased number of patients are required to validate these results.

Adult↗

PubMed2006

Computer-aided detection of solid lung nodules in lossy compressed multidetector computed tomography chest exams.

RATIONALE AND OBJECTIVES: To assess the effect of three-dimensional (3D) lossy image compression of multidetector computed tomography chest scans on computer-aided detection (CAD) of solid lung nodules greater than 4 mm in size. MATERIALS AND METHODS: A total of 120 cases, acquired with 1.25-mm collimation, were collected from 5 different sites, of which 66/120 were low-dose cases. Two chest radiologists established that 37 cases had no actionable lung nodules; the remaining 83 cases contained 169 nodules (range 3.8-35.0 mm, mean 5.8 mm +/- 3.0 [SD]). All cases were compressed using the 3D Set Partitioning in Hierarchical Trees algorithm to 24:1, 48:1, and 96:1 levels. A study of the effect of compression on computer-aided detection (CAD) sensitivity was performed at operating points of 2.5 false marks (FM), 5 FM, and 10 FM per case using McNemar's test. Logistic regression models were used to evaluate the impact on CAD sensitivity by compression level on nodule and image characteristics. RESULTS: Compared with no compression, there was no significant degradation in CAD sensitivity found at any of the studied compression levels and operating points. However, between compression levels, there was marginal association with sensitivity. Specifically, 24:1 level was significantly better than 96:1 at all operating points, and occasionally better than no compression at 10 FM/case. Based on multivariate analysis, nodule location was found to be a significant predictor (P = .01) with a lower sensitivity associated with juxtapleural nodules. Nodule size, dose, reconstruction filter, and contrast medium were not significant predictors. CONCLUSION: CAD detection performance of solid lung nodules did not suffer until 48:1 compression.

Algorithms↗